This paper presents a wearable microsystem for minimally invasive, autonomous, and pseudo-continuous blood glucose monitoring, addressing a growing demand for replacing tedious fingerpricking tests for diabetic patients. Unlike prevalent solutions which estimate blood glucose levels from interstitial fluids or tears, our design extracts a whole blood sample from a small lanced skin wound using a novel shape memory alloy (SMA)-based microactuator and directly measures the blood glucose level from the sample. In vitro characterization determined that the SMA microactuator produced penetration force of 225 gf, penetration depth of 3.55 mm, and consumed approximately 5.56 mW·h for triggering. The microactuation mechanism was also evaluated by extracting blood samples from the wrist of four human volunteers. A total of 19 out of 23 actuations successfully reached capillary vessels below the wrists producing blood droplets on the surface of the skin. The integrated potentiostat-based glucose sensing circuit of our e-Mosquito device also showed a good linear correlation (R2 = 0.9733) with measurements using standard blood glucose monitoring technology. These proof-of-concept studies demonstrate the feasibility of the e-Mosquito microsystem for autonomous intermittent blood glucose monitoring.